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Spinal stenosis and vascular stenosis are very similar in symptoms. The word stenosis means that something has narrowed. Spinal stenosis is a narrowing of the spine, while vascular stenosis is a narrowing of the blood vessels. Despite these different diseases, the symptoms are similar, and even doctors often perform the wrong surgery or treatment.
If vascular stenosis is mistaken for spinal stenosis, surgery will not only cause unnecessary damage but may actually worsen the vascular stenosis. In spinal surgery, even a simple surgery requires you to stay in the same position for more than 1 hour and lie down for another day. Therefore, it is important to differentiate between spinal stenosis and vascular stenosis.
What spinal stenosis and vascular stenosis have in common is first of all numbness and pulling in the legs. Even when you go to the nearby laundromat or convenience store, you take a break along the way. It develops a condition called intermittent claudication.
However, although the symptoms are similar, the causes of each are different. Patients with spinal stenosis have narrowed nerves in their lower back, and when that happens, the nerves that go down the legs are compressed, causing cramps. However, patients with vascular stenosis, or vasoocclusive disease, have numbness due to a blockage in the aorta that flows to the leg, and it has nothing to do with nerves.
So, how do we differentiate between spinal stenosis and vascular stenosis? There are slight differences in symptoms that seem similar at first glance. For example, if the blood vessels are narrowed, the problem is cramps and numbness in the legs, but the strength of the legs does not weaken. However, if the nerve itself is pinched, the more you walk, the more strength in your legs will decrease. So, if you only have narrowed blood vessels, you can stop for a while while walking, but if you have spinal stenosis, you should stop and sit.
In addition, people with spinal stenosis have a harder time going downhill than going uphill. This is because when you go uphill, you bend your back, but when you go downhill, your nerve pathways narrow as you straighten your back. However, patients with vascular stenosis have a harder time going uphill than going downhill. Blood vessels carry blood to the muscles. Compared to downhill, going uphill is bound to be harder because the exercise is more intense and uses a lot of muscles.
It's also about what you see. Spinal stenosis can also cause thinning of the legs. This is because when a nerve is compressed for a long time, the muscles shrink. However, if the blood vessels are narrowed, the legs will swell even more. In particular, varicose veins are easy to see with the naked eye due to the accumulation of blood substances such as lactic acid. If you are a woman, if you wear a skirt, your calves will stand out.
One difference is that patients with vascular stenosis have a hard time palpable the pulse on the top of their feet, while spinal stenosis has a palpable vein.
Other tests include shopping cart signs and bicycle tests that use the difference between spinal stenosis and vascular stenosis. You've probably seen wheeled shopping carts in supermarkets a lot. When patients with spinal stenosis hold a shopping cart and bend their backs, the nerve pathways open up and they can move easily. However, patients with vascular stenosis do not improve their symptoms by using a shopping cart. The same goes for bikes. Just sitting on a bicycle causes spinal stenosis patients to open up their nerve pathways. However, if the blood vessels are narrowed, the symptoms do not improve whether the person bends or leans back. Using this, the actual physical therapy room can also differentiate between the two diseases through indoor cycling exercises.
If you have a combination of vascular and spinal disorders, vascular treatment will be prioritized unless you have symptoms of numbness or placebo. Spinal surgery can adversely affect blood vessels, When vascular disease worsens, necrosis occurs due to poor blood circulation. That's why blood vessels are examined before spinal surgery is performed or blood clot prevention devices are used.
In fact, when the hospital collected data on patients who had scheduled spinal surgery for two years, it was found that nearly 330 patients had poor blood vessels. If we hadn't done the vascular tests, about 330 patients could have had complications, and we could have had spinal surgery that we didn't have to rush into. For this reason, those who are planning to undergo spinal surgery should definitely have a vascular examination of the lower extremities. Doctors who examine patients who suspect spinal stenosis should also consider vascular problems.
In conclusion, spinal surgery should not be decided in a hurry. This is because spinal stenosis and vascular stenosis share similar symptoms, and if done incorrectly, not only will you have to perform unnecessary surgery, but the surgery can also lead to complications in the blood vessels. It is true that spinal disorders should be suspected when there are symptoms of numbness in the legs and lameness, but vascular diseases should also be considered. If spinal and vascular diseases are comorbid, vascular treatment should generally be prioritized.
Regardless of the department, such as anesthesiology and pain medicine, neurosurgery, rehabilitation medicine, and orthopedics, pain treatment is no different.
If you have a spinal condition, the indoor cycling exercise I mentioned earlier can be helpful. We also recommend walking. If you're exercising outside, it's a good idea to use hiking sticks to avoid injury, and stop to take breaks in between.
Itching is often not related to the spine. However, there are some people who complain of abnormal sensations as the sensation returns to the areas that were dulled after spinal treatment. They use drugs that calm nerves, such as steroids and pregabalin.
Bending down may provide temporary relief, but it can only cause deformity after the waist is bent. Of course, if you're in a lot of acute pain, it can be helpful to bend over. However, you should avoid bending your back on a daily basis and treat it first
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